Living with the COVID-19 pandemic for a year, it’s hard to process the numbers. What we know is that nearly 500,000 Americans have lost their lives, and that Black, Latino, and Indigenous people are worst impacted.

But behind the statistics are stories, and on the latest episode of The Dose, we listen to one of those stories. Our guest, Magdala Chery, D.O., is a primary care physician and Commonwealth Fund Fellow in Minority Health Policy.

Magdala is also a daughter, and she experienced firsthand the racial inequities of our health care system when she lost both her parents to COVID-19 last spring. Magdala speaks of her personal tragedy without rancor: she believes that sharing stories like hers will help us see the people of color affected by COVID-19 not as case numbers and fatalities, but as lives.

Transcript

SHANOOR SEERVAI: When we talk about how the COVID-19 pandemic disproportionately impacts people of color, we talk in numbers, cases, hospitalizations, deaths. We often forget that there’s a person, a family, a story behind each statistic. On today’s episode of The Dose, we’re going to listen to one story. My guest is Magdala Chery, a primary care physician and assistant professor of medicine in New Jersey, and a Commonwealth Fund Fellow in Minority Health Policy. Magdala is also a daughter, and experienced firsthand the racial inequities of our health care system.

Magdala, welcome to the show.

MAGDALA CHERY: Thank you for having me.

SHANOOR SEERVAI: Tell me about your family and about how COVID-19 has impacted all of you.

MAGDALA CHERY: Yes, absolutely. So my background is Haitian. Both of my parents immigrated here from Haiti, worked blue collar jobs, were not educated in the States, as far as going to college or higher education. So, quote unquote, I am the American dream for my family. My success is what they came to this country for. But a lot of people don’t like to talk about the other aspect of that American dream is the burden of being the answer for your family. You are revered as the one who knows it all, and you quite often have responsibilities other than just being present and succeeding, but also financial, if something’s coming down, you’re responsible for figuring out what we’re going to do next. In that case, the minute I heard what was happening, I’m automatically thinking about my family.

My mother is chronically ill. She has, at the time, has Parkinson’s disease, hypertension, diabetes. She worked as a certified nursing assistant all her life. My father used to be a factory worker, right when I was starting med school, lost his job. And at the same time my mom was getting sick. So he was her chronic caregiver as well. So for me, I’m thinking, what does this mean for my family? What do I have to do? So I was like, let me go home and check one more time and make sure they’re good and also relay to them how serious this was.

And also, try to tell my father, who’s a preacher, he’s an evangelist. He also preaches on the radio and he goes to different churches to say, “I need you to stay put. I know it’s going to be hard for you, but I need you to just stay put because there’s something really bad out here.” And he still went to church that Sunday, because it’s just a huge part of who he is. So that Sunday is March 15th. And in hindsight, I would realize so many people from our church, my childhood church, would get sick after that Sunday. About seven days later, so probably March 22nd, he starts developing symptoms but does not tell me. And I don’t find out until about March 25th when my mother would tell me secretly, “I need you to come check on your dad. He is not okay.”

SHANOOR SEERVAI: And so 10 days later you say your mother calls you, says your dad has symptoms. What happens next?

MAGDALA CHERY: So about the 26th, when he said that, I worked earlier that day and then I decided to go bring in my full PPE and go check on him. And he looked like he had lost at least 10 pounds from the last time I saw him that 15th weekend, like he looked that small. He looked weak, he looked dehydrated, was still breathing okay, but very slow. And given everything I had heard, was if they can, they can maintain themselves at home. So made sure they had food, stocked up the fridge, Tylenol, everything we were told to do and watch at home. Gave him instructions and said, “You’re going to FaceTime me every day. We’re going to check on you and see how you’re doing.”

SHANOOR SEERVAI: A few days later, you realize you can’t take care of your father at home. You need to take him to a hospital. But you need to convince him first. Tell me about that conversation.

MAGDALA CHERY: I get home, put on my PPE, get in the house. He did not look like himself. He looked even smaller than what I saw a few days ago. I also did his pulse-ox. It’s like 80, 81 percent and dipping. And he’s just laying there. I remember texting friends from residency in a group chat, I can’t figure this out. Right. I just got to make sure that I’m not going crazy, that he has to go into the hospital. Because the whole time he’s like, “I’m not going. I’m not going.” And I remember the moment where I see him belly breathing while he’s laying down and I’m like, this is bad. This is where, in the hospital, as a resident, I would be saying anesthesia stat. We have to put in something down his throat to help him breathe. I get on my knees and I’m like, “Dad, I can’t help you. I can’t do this. I have no oxygen here. I don’t have what I need to take care of you. I cannot do this.”

And he’s adamant about not going. He says, “I’m just an immigrant. I’m just a Black person. I have an accent. They’re not going to care about me. They’re not going to let you stay. You know I won’t go if you’re not in there. And you know I can’t afford this. You know how hard it is to even manage your mother’s medical care. I can’t afford to take on any bills.” And at that moment, I’m like, “We’ll figure it out. I’ll figure it out. I don’t care. You have to go. Please, I’m begging you to go.” And that’s when he makes his own request and agrees to go with me.

SHANOOR SEERVAI: And so now let’s go to that scene in the hospital, when you took your dad. And some of these fears that he had, he said, “I don’t want to go. They’ll just see me as a Black person.” When you were at the hospital, what did you see that played into those fears?

MAGDALA CHERY: So we get to the hospital, I choose this, and I’m specifically going to say this, I think it’s important. I choose this hospital. It’s seven minutes away from my house. There’s several other hospitals, but I’m going to deem this, I go to the Black hospital because this hospital is in an underserved area. It services Black and Brown people primarily. And it’s a community hospital. But the currency that I’m playing in my mind is my father said, “I won’t go unless you know someone.” And I knew another fellow doctor there, a Black doctor in the emergency room. And you have to be able to try to stay with me until you can’t stay anymore. So I had to play on that in my mind. And then I had to play on in my mind when I can’t stay, what will happen? So I need to be at a hospital where I know he’ll see other people who look like him, who possibly speak Creole as well. So he’ll feel comfortable and he’ll feel seen there.

So I get to this hospital. My father can barely walk the 100 feet from the car to the entrance, which should have taken two minutes and ended up taking us about six to eight minutes to get there. Then minute he gets to the door, they have to pull out a chair because he’s about to pass out and we give him some oxygen. We finally get a bed, and when I say a bed, into the emergency room in where they’re servicing COVID patients. And all I see is Black and Brown people. And again, I know this hospital usually services the community, but the volume of Black and Brown people is what shook me. And I heard people speaking different languages who could speak, people struggling, people saying, “No, no, no, I don’t want that tube,” and having accents.

I see no translators. I see a lack of staff and overwhelmingness. And I tell you, I’m an internal medicine physician. I worked in an area where I’ve seen different types of hospitals, settings. I’ve never seen this before. Never seen something like, it was almost equivalent to a war zone. That’s the words I can use. And while there, every 30 minutes, there was a code blue, which means that someone’s essentially dead and we’re trying to bring them back. There’s a code for an anesthesia stat, which means someone’s struggling to breathe and they’re going to put something down their throat. And I’ll never forget the moment I heard someone say, “Listen, we don’t have any more oxygen tanks. We can’t handle getting more people.” And I sat there and said, “Wow, this is not on TV. This is not being reported.” And at that time, remember this is March 30th, we’re not getting racial data, right? We have no idea what it really looks like on the ground. And I’ll never forget that scene forever.

SHANOOR SEERVAI: That’s a really, really powerful scene. And as you say, there was no reporting, it wasn’t on TV. It must’ve been really scary for you to leave your dad in that hospital.

MAGDALA CHERY: Absolutely. So it took us 24 hours to finally get a bed. They had one hospitalist for COVID patients. I specifically remember the emergency room attending saying, “I put him up for admission. He’s going to definitely get admitted. He needs to, but your dad is number 22 on the list. And one person working.” I don’t mean to laugh, but I couldn’t believe that was happening. And this is me advocating. So it might’ve taken longer. I’m going to admit to my privilege as a physician, to speed him up the line, if I’m being honest. I get up there and the most uncomfortable thing about why it was hard for me to leave the hospital was once I got up there, no one told me what the plan was. I left my phone number. They gave me some pieces. I didn’t want to make them uncomfortable because I understood why they needed to isolate us. But I didn’t leave feeling okay, when I left the hospital.

SHANOOR SEERVAI: And I can only imagine how hard it is to talk about this. But this hospital where you left your dad is ultimately where he lost his life. Can you talk a little bit about his last days and what ultimately happened before he passed?

MAGDALA CHERY: Yeah. So the only reason I have a true sense of his last days is again, out of privilege. When I was leaving, I requested that I be able to come back and drop off a iPhone. And that’s the way that I can even get any information because I was getting no updates from the staff. Hold up your phone, turn it around, let me see what bag is up. Let me see where your oxygen is connected. There’s no monitor. Let me see the stickies on your chest to see if they can tell me if they did an EKG. Literally piecemealing the story to myself because I was at the mercy of a staff member who would be generous enough, and I hate to use that word, but really generous enough to call and give me an update. And that’s with them knowing I’m a physician and I couldn’t get that information.

So things he would tell me when he would call me, he would call me crying for water. Throat was really dry because he’s wearing an oxygen mask, has high oxygen requirements. Trying to get someone in the room was difficult. Trying to get someone to help him to use the bathroom was difficult. Any assistance he needed was very hard. And multiple times he would call me and say, “Bring me home. I’m going to die here. Just bring me home. I don’t want to be here anymore. They don’t see me.” And that was tough. Hearing those words, but knowing he still had high oxygen requirements was really hard for me.

And I even remember right before Easter weekend, which is the weekend he would end up passing, I had spoken to an attending finally, and I said, “He wants to really come home. Can you get me some oxygen? I resume the risk. I’ve cleaned out a space for him in the house. I’m willing to take care of him.” And that’s when the doctor admitted, “We haven’t been able to send people home with oxygen. We don’t have the equipment. We don’t have the supplies. I will try my best. My hope is he’s the best-looking one on the floor. He hasn’t had to be intubated, his oxygen requirements wax and waned, but we’ve been seeing this. Just maybe through the weekend, we can get him to a place of being more stable. That is my hope, but I can’t guarantee anything.” I spoke to him every day up until the day of his death. The Saturday, April 11th, before he dies, I talked to him. He doesn’t sound that great. He doesn’t look that great.

I say, “Okay, can you just rest? Don’t worry about calling me. Just get some rest, let your body rest. Sleep, lay on your side to help open up your lungs and I’ll check in with you.” But I expected to hear from him the next day. And then at 6:00 AM, my sister’s shook me out of bed. And she said, “Your phone keeps ringing,” and that’s when I saw the numbers and the area code. And I said, “Oh, I think I know what phone call this is. I think I know what this is.”

And I call back and I’m like, “This is Magdala Chery. I’m calling. Someone kept calling me.” He’s like, “Yes, are you Mario Chery’s daughter?” And I said, “Yes.” And all he said, all he started with is “I’m very sorry,” and I knew where we were going. It actually took me 30, 45 minutes to call back and say, “I need the truth. How did he die?” And he said, “Unfortunately, we found him on the bathroom floor. We weren’t monitoring his oxygen. He must’ve got up to go to the bathroom, and that’s where we found him. By the time we found him, we tried to resuscitate him and bring him back and we couldn’t. It was already too late.”

SHANOOR SEERVAI: I’m really sorry to hear this. I really am. I want to go back to something that your dad said to you, “They don’t see me.” How did that make you feel? Do you think that that is why your dad ultimately didn’t get the care that he needed?

MAGDALA CHERY: I do. And the reason why I do is because even before COVID, I saw that. Historically, it’s a tough historical truth. Historically, we don’t see Black people in health care. We don’t truly see them. And a lot of times we just see them as bodies. We just see them as statistics, as disparities. So when he said that, I understood, but I’m limited. I’m in this position where now I am standing and talking to him as a daughter, as a doctor, as a Black woman, trying to process everything happening and knowing his words are absolutely spot on. And that is what made it difficult because even with my privilege, I could not override a system that doesn’t see Black people.

SHANOOR SEERVAI: You’re talking about our health system, which doesn’t see Black people. And this has existed for a long time. Now COVID-19 has drawn attention to these disparities. We know that Black and Latino people are dying at much higher rates than white people. But what are we going to do about it?

MAGDALA CHERY: We need to know the stories. This is why I’ve chosen to speak up about my father’s story. People always say, “I can imagine this is really painful.” And it is, but you know what I see? I see an amplified narrative of what is happening that people don’t know about or people know about and they refuse to speak up, or families are too scared to share what’s happening. So when I use my voice to share my family’s story, to share my father’s story, my mother’s story, what I’m really doing is saying to all of us, “Can we step back and stop looking at these case numbers, at these fatalities and call them lives, lives we could not afford to lose? We failed them.”

SHANOOR SEERVAI: And when we think of this failure, maybe let’s take a step back in the timeline and go back to March 15th when you said that your dad and several other people in your community went to church. Do you think that your dad and people in his community knew how dangerous it was to be outside, to be with other people?

MAGDALA CHERY: Absolutely not. Absolutely not. I think they saw this, if you remember, it’s just like another flu, right? And even though people die from the flu, how much have we really seen people die from the flu? Unless you’re in the medical profession, you don’t know that. So conceptually, they can’t see it. What we fail to do is speak the language of the people. What do I mean by that? So if you think back to when sports was canceled, that is when it hit home on social media, that something big must be happening, that we won’t allow a very big money-generating industry proceed as usual because we’re scared about something, right? So I remember even using that as my example amongst my friends and family. I remember my dad, he’s a big NBA fan and we used to watch basketball games together. That’s what I used to have the conversation.

The thing is, this is a dialogue, this conversation in a language they understand, needs to happen over and over. Repetition is what was going to give it power. Not only was it repetition, it’s also having the right people deliver that message. So representation into those communities to warn since January that this is on the horizon since February to have this conversation about what’s to come in a language they understand by people who look like them and people they trust. I really believe if we were able to do that, we might have been able to see a different outcome because that kind of conversation happening in that context in their community allows us to not talk about COVID-19 in this pandemic from our privileged lens. And an example of that is when they said quarantine. Some people couldn’t quarantine in their homes. That’s not realistic. How are you quarantining in a one-bedroom apartment, while you see other people saying quarantine and they’re in separate houses. They’re in a guest house, they’re in a mansion where they quarantine with a whole floor. That is not the reality for a lot of these people.

SHANOOR SEERVAI: Right. And when you say quarantine, it also makes me think about working remotely. You talked a little bit about how you were to transition to telehealth in your practice. And there are people who were able to stay home. But there are people who work jobs, which you can’t do from home. You can’t buy groceries from your apartment. So what do you do? You keep going to work, right?

MAGDALA CHERY: Exactly. Exactly. And those people were not having PPE, right? And those jobs such as the grocery bagger, the person who works at the bus stop, your bus driver, the gas station attendant, all those people were essential workers, right? Who didn’t even have protection. And those jobs are usually represented by Black and Brown people, right? So it’s adding up as to why this is translating to disproportional fatalities, but people are not understanding and putting that full picture together.

SHANOOR SEERVAI: So at the beginning there wasn’t a lot of information and information, as you’ve talked about, wasn’t conveyed in a way that people could really understand the severity of the situation. But we’re speaking at the end of January, and we’ve now been living with this pandemic for one year. Have things gotten better now that there is some more information?

MAGDALA CHERY: I’m going to be bold and say no. We’re still in a pandemic and are we really doing anything different? We’re not. And we see that quite distinctly with vaccine distribution, right? And what’s bothering me about the context about that is you hear a lot about the vaccine hesitancy, which is completely warranted. But you’re not hearing enough about why that exists and what we’re doing about it and how we’re making sure we achieve equity in that realm.

SHANOOR SEERVAI: How can we build trust in communities of color, around the COVID-19 vaccine?

MAGDALA CHERY: So I think before we can actually tackle the vaccine hesitancy, one thing that I think is a powerful tool is telling the truth. We need to tell the unfiltered truth about how we didn’t prepare and we hurt communities of color in this pandemic. And here’s why that’s important. That is the framework by which people cannot trust if they really should take this vaccine because to them, what appears to be rushed also appears, why do you care about me now? You didn’t care about me when this pandemic was happening. You didn’t care about me before the pandemic happened. You didn’t prioritize me. And now you want to shame me and guilt me for asking questions about a vaccine that doesn’t make sense to me.

Because there hasn’t been any truth, any true apology about what has happened, we’re carrying that stain as we go into this vaccine distribution policy. Start off with an “I’m sorry. We failed communities. And knowing this failure, we’re going to put you first.” So the next part is prioritizing vulnerable populations, prioritizing communities of color. And that means we do things differently. That means we go to them with this vaccine information. We go to them and build sites in their community. We go to them and speak the language they understand and address their concerns. That doesn’t transfer to everyone getting the vaccine. But what it does transfer to is building trust and allowing them to truly make an informed decision about what they want to do next.

SHANOOR SEERVAI: So how do you do that? How do you prioritize, as you say, communities of color? How do you go to them and say, “We are sorry and now we have this vaccine, you are first”?

MAGDALA CHERY: So this has to start from the top up. So this has to start from the administration. So it has to really be something that starts from the White House down. And then in these communities, we cannot come in as saviors, right? And that includes myself. I may be a Black woman, I may have Haitian descent, but all Black is not a monolith. Communities of color are not monoliths. So now that we are admitting to our wrongs and we are apologizing and we’re ready to build trust, we have to tip into those communities to say, who are the people, who are the organizations and the institutions that the community trusts, and partner with them. Again, it’s not a convincing or swaying to our side. It’s building a bridge, a bridge so honest dialogue, accurate information can crossover. And now that you have this trusted partner with you, have these conversations and again, bring the vaccine to them.

SHANOOR SEERVAI: So who is the right partner in, for example, your parents’ Haitian community in Essex County, New Jersey?

MAGDALA CHERY: That’s a great question. So the right partner is going to differ based on region, location, and the context of that community. If I can speak to my own community, it would be pastors, it would be the church, it would be barbershop owners. And we’ve seen studies where that has been done. So that’s not new. It would be the bodega. It would be so many of these partners. It’s also another reason why I’ve decided to speak up. Having my privilege of being a physician is one thing, but having my relatability as a person who’s grown up in the church who understands faith values, I can speak another language.

So when I choose to share this information, it’s also a way to build that trust and really think of partnerships with my community to really convey true, honest, accurate information. So I’m an example. Not only am I a doctor, but I’m a great way to get information and partner with state officials and local officials to say, “What don’t you know? What are the questions the community is asking? What is your church saying to you? Are they scared?” Tell me, and then I can come in and bring some information and let them know where to go, what to be thinking about, how to make the most appropriate decision.

SHANOOR SEERVAI: I want to end talking about your decision to tell your family’s story. You started a campaign called Not Just A Black Body. What do you hope your campaign will accomplish?

MAGDALA CHERY: If you don’t mind, I wanted to mention something about my mother as well, who passed away from complications of COVID-19, because it will talk about this campaign as well too. So my mother ultimately pass away on May 1st, my dad died April 12th. And my mother, she was sick while my dad was in the hospital. But I took care of her at home. She made it clear she did not want to go to the hospital. She saw we were struggling to get information. She knew she was not letting me leave her or letting my sister leave her as well. Because we had contact and we had exposure, we had no one, we weren’t allowed to have anyone in the home. So I became her caregiver at home. But I’m sharing this because even in her decision to die on her own terms and at home, it was a beautiful experience that I really wish more families had because my father was not allowed to die in dignity.

But my mother and choosing her ability to say, “I want to die the way that I want to die. I want to die with my family,” really helped me see how it’s so important for us to look at these lives lost as not just bodies but lives and honoring their wishes and even in death, finding a way to give them dignity. So the campaign, Not Just A Black Body campaign that I started and turned into an organization, was initially birthed when I saw what was happening to my father and his fear of being seen as just a Black body, right? And wanting to say, he’s not just a Black body, he’s a father or a community leader or grandpa, a husband. But it really also became a campaign about how do I amplify these stories using COVID-19 as an accelerator. It’s not new what we know to exist as far as social determinants of health and political determinants of health that has caused this disparity in our communities.

But do we know the full context of these stories, of these Black bodies? They’re more than just bodies, they’re lives, they’re people. They represent so much in their community that we couldn’t afford to lose. So with my campaign, we have taken the idea of knowing these stories and saying, how can we push a mission of restorative justice in the health care system, specifically for vulnerable populations, with a particular interest at looking at Black communities? How can we look for restorative justice to think about how we can reshape and recreate a system of healing that has Black bodies and Black communities at the center? So what the campaign initially started off as a means of getting information by someone who looks like my community so they can understand how serious this was. Especially early on in the pandemic has shifted in a means of being a voice and helping to amplify stories, not just COVID stories, but other stories of Black people that they encounter in the health care system that we need to know about and using those stories to say, how do we shift and change things in health care?

SHANOOR SEERVAI: The Dose is hosted by me, Shanoor Seervai. I produce this show for the Commonwealth Fund along with Andrea Muraskin, Naomi Leibowitz, and Joshua Tallman. Special thanks to Barry Scholl for editorial support, Jen Wilson and Rose Wong for our art and design, and Paul Frame for web support. Our theme music is “Arizona Moon” by Blue Dot Sessions, with additional music from Podington Bear. Our website is thedose.show. There, you’ll find show notes and other resources. That’s it for The Dose. Thanks for listening.

Show Notes

Bio: Magdala Chery

Website: Not Just A Black Body Campaign